Evidence map›Paper›PMID 41286909›Full record

Trial reportBMC complementary medicine and therapies2025

Adding tibial nerve neurodynamic techniques to a rehabilitative pain management strategy improved neuropathy severity and quality of life in patients with diabetic peripheral neuropathy: a randomized sham-controlled trial.

Mahdi Ashoori, Seyed Ebrahim Hashemi, Mohammadreza Pourahmadi, Mehdi Dadgoo, Mahboobeh Sadat Hosseini, Hasti Lotfi, Maryam Ahmadi

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC complementary medicine and therapies, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mahdi AshooriIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran All., Shahnazari St., Madar Sq., Mirdamad Blvd, Tehran, Iran.
Seyed Ebrahim HashemiExercise Physiology Research Center, Life Style Institute, Baqiyatallah al-Azam Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Mohammadreza PourahmadiIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran All., Shahnazari St., Madar Sq., Mirdamad Blvd, Tehran, Iran. pourahmadipt@gmail.com.
Mehdi DadgooIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran All., Shahnazari St., Madar Sq., Mirdamad Blvd, Tehran, Iran.
Mahboobeh Sadat HosseiniHealth Research Center, Baqiyatallah al-Azam Hospital, Life Style Institute, Baqiyatallah University of Medical Science, Tehran, Iran.
Hasti LotfiIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran All., Shahnazari St., Madar Sq., Mirdamad Blvd, Tehran, Iran.
Maryam AhmadiIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran All., Shahnazari St., Madar Sq., Mirdamad Blvd, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetic Peripheral Neuropathy (DPN), affects 30% of type 2 diabetics, leading to severe foot problems. Existing treatments offer limited efficacy. This randomized controlled trial explores Neurodynamic Techniques (NDTs) for their impact on neuropathy severity, quality of life (QoL), nerve function, range of motion (ROM), and nerve mechanosensitivity in DPN patients.

methodsForty DPN patients, confirmed by electrodiagnostic and laboratory tests, were randomized into real and sham tibial NDT groups. Both groups received a basic complementary treatment plus their respective NDTs. Outcome measurements included Michigan Diabetic Neuropathy Score (MDNS), QoL, tibial nerve conduction velocity, distal latency, amplitude of compound muscle action potential, F-wave latency, plantarflexion straight leg raise (PFSLR) ROM and dorsiflexion SLR (DFSLR) ROM tested to the first onset of symptoms (P1) and maximally tolerated symptoms (P2), and nerve mechanosensitivity.

resultsMDNS demonstrated a significant improvement, with a mean difference (MD) of -4.60, indicating a large effect size (Cohen's d: -0.93) and surpassing the minimal clinically important difference (MCID) of 2.48, with a P-value of 0.001. QoL improved significantly (MD: -13.25, Cohen's d: -0.73, MCID: 9.00, P-value: 0.006). Nerve conduction parameters remained unchanged. Small to medium effects were observed in PFSLRP1 ROM for both limbs (right limb MD: 3.35, Cohen's d: 0.38, MCID: 4.42, P-value: 0.05; left limb MD: 4.40, Cohen's d: 0.56, MCID: 3.88, P-value: 0.06), and both limbs' PFSLRP2 ROM (right limb MD: 2.10, Cohen's d: 0.21, MCID: 4.80, P-value: 0.07; left limb MD: 4.80, Cohen's d: 0.57, MCID: 4.17, P-value: 0.05). Left DFSLRP1 ROM also improved (MD: 2.35, Cohen's d: 0.29, MCID: 4.07, P-value: 0.04). Left tibial mechanosensitivity to P1 improved significantly (MD: 2.05, Cohen's d: 0.64, MCID: 1.57, P-value: 0.04). Other DFSLR ROM outcomes and other mechanosensitivity outcomes remained unchanged throughout this trial.

conclusionsWhile NDTs did not enhance nerve conduction parameters, they significantly reduced neuropathy severity and improved QoL and PFSLR ROM in individuals with DPN.

trial registrationThis study has been pre-registered at https://www.irct.ir/ , (registration number: IRCT20220401054379N1) on October 13, 2022.

Indexed as

Diabetic NeuropathiesPain ManagementQuality of LifeTibial NerveAdultAgedFemaleHumansMaleMiddle AgedNeural ConductionSeverity of Illness IndexDiabetic neuropathyElectromyographyNerve conduction studiesNerve mobilizationNeurodynamic techniquesPeripheral nervesRange of motion

Identifiers

PMID41286909
PMCPMC12642109

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.